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At least 19 recordsLinked to original sources
PubMedDate not supplied

[Cervical electrostimulation in some vestibular diseases].

Vestibular disorders may be treated by means of drugs, surgical tools or rehabilitation. Cervical electrostimulation may be regarded as physical therapy and its activity is connected to neural pathways between cervical receptors and vestibular nuclei. In present study electrodes were placed lateral to cervical column on the opposite side of vestibular deficit as pointed by electronystagmography; stimulus duration was 18 msec and frequency 100 Hz. Every stimulation lasts for 30 minutes and were repeated twice a week for a total number of 10. The ability to adjust vestibulo-ocular reflex was evaluated by means of a Compensatory Index. The following materials were enrolled in the study: 20 normal subjects were observed before and after a cycle of stimulations: 24 patients suffering from acute labyrinthitis or neuritis, 48 cervical vertigo, 8 cervical traumatic injures and 3 patients operated for acoustical neuroma. All these groups were coupled with control groups composed of the same pathology and the same number of subjects. Statistical treatment of reports was evaluated by t-student test before therapy after one month and after 3 months. Results point out good effects of electrostimulation on vestibulo-ocular reflex compensation, especially in cervical vertigo and labyrinthitis or neuritis with respect to control groups. No important results were obtained in neuroma group and in normal subjects. Electrostimulation may act on vestibular nuclei by direct spino-vestibular pathway but also by repeated decompensations mainly mediated via the cerebellum or spino-reticular connections.

Electric Stimulation Therapy↗
PubMed2002

Is hyperventilation-induced nystagmus more common in retrocochlear vestibular disease than in end-organ vestibular disease?

Hyperventilation-induced nystagmus (HVIN) has previously been shown by the senior author to be common in patients with both acoustic neuromas and following resection. The recurrent study's aim was to examine if HVIN was specific for retrocochlear pathology. To test this, the incidence of HVIN in 24 patients with confirmed acoustic neuroma was compared with its incidence in 38 patients with end-organ vestibular disease (defined as a greater than 25% reduction in caloric testing). Hyperventilation was carried out for 90 seconds. The results showed that 58% of the acoustic neuroma group were positive for HVIN versus 18% of the end-organ group. This difference was very significant on chi-square testing (p < .002). Hyperventilation-induced nystagmus appears to be much more prevalent in retrocochlear pathology than in end-organ pathology.

Adult↗
PubMed1997

Surgical treatment of uncompensated vestibular disease.

Uncompensated vestibular disease is a serious, disabling disorder that substantially alters quality of life. Fortunately, most dizziness and vestibular disorders are managed conservatively or with medications and are self-limited. When medical management is unsuccessful, however, there is a wide array of surgical interventions that can significantly improve the symptoms. This article reviews the broad array of surgical techniques available for managing dizziness.

Cerebellopontine Angle↗
PubMed2002

Head shaking nystagmus in the follow-up of patients with vestibular diseases.

We examined 420 patients with vestibular diseases of different origin; 273 with peripheral vestibular disease and 147 with both peripheral and central vestibular disease. Recurrent vestibulopathy like Menière's disease, or benign paroxysmal positional vertigo, were not included. Patients were evaluated initially and 6 months after pharmacological and/or rehabilitation therapy. At the initial assessment, the head-shaking test was specific for the side of the lesion in both groups, even if spontaneous nystagmus was no longer present. Thus, head-shaking nystagmus is a physical sign that can be easily evoked and gives useful information about the presence of vestibulo-ocular reflex asymmetry. At the follow-up at 6 months, many changes in the head-shaking nystagmus were noted: in some cases it appeared, in some others it changed direction and more often it disappeared. There is actually no acceptable explanation for the disappearance of the head-shaking nystagmus, despite some evidence that vestibular compensation could play a role. It is definitely proved that sensitivity of the head-shaking test is really poor, especially in the course of time and, therefore, it should not be used alone in the follow-up of patients with vestibular disease.

Adult↗
PubMed1982

[Enhanced variability of the thermal test with patients with vestibular disease (author's transl)].

The reproducibility of nystagmus-intensity was measured with patients with peripheral vestibular disease, and with healthy persons, by a fivefold repetition of the same thermal stimulus. Variability of the data of the patients was considerably higher than of the healthy persons. Thus, the "normal" data have only a restricted value. Therefore, interpretation of thermal tests is more difficult for patients with an eventual vestibular disease. The origin of the enhanced variability seems to be the weakness of the reaction per se, because strong stimuli and hence strong reactions with healthy persons, have a lower relative standard deviation. Furthermore, tonic fluctuation in the diseased vestibular system is probable, as healthy ears of patients with unilateral vestibular disease show increased variability. An improvement of the method of the test is necessary. This can, for instance be achieved by an examination with eyes open under Frenzel's glasses and by repeated, by short and by strong stimuli.

Ear Diseases↗
PubMed1997

Evaluation of health-related quality of life in individuals with vestibular disease using disease-specific and general outcome measures.

BACKGROUND AND PURPOSE: The Dizziness Handicap Inventory (DHI) is a condition-specific health status measure for persons with vestibular disease, and the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) is a generic health status assessment. The purposes of this study were (1) to describe the relationship between the DHI and the SF-36, (2) to examine the reliability and responsiveness of these measures for persons in a vestibular rehabilitation program, and (3) to compare health-related quality of life between individuals with vestibular disease and the general population. SUBJECTS: Ninety-five patients, aged 25 to 88 years (mean = 57.0, SD = 14.9), were assessed. METHODS: To determine reliability, 20 subjects completed both questionnaires twice, 24 to 48 hours apart. Thirty-one subjects completed both questionnaires before and after 6 to 8 weeks of vestibular rehabilitation to establish responsiveness. To establish the relationship between the two assessment tools, 95 subjects completed both questionnaires. RESULTS: Each test was moderately to highly reliable (intraclass correlation coefficients [2, 1] = .64-.95), but the tests were poorly to moderately correlated to each other (r = .11-.71). The DHI was more responsive to change than the SF-36. The SF-36 scores of individuals were lower than scores of the general population. CONCLUSION AND DISCUSSION: The DHI and the SF-36 provide reliable and responsive measurements, but they appear to provide different information about the health status of patients with vestibular disease. Compared with the general population, patients with vestibular disease had lower scores for health-related quality of life, but these scores improved after 6 to 8 weeks of treatment. Future studies should clarify whether this improved health status is due to vestibular rehabilitation.

Activities of Daily Living↗
PubMed2001

[Commentaries on the complication of vestibular diseases].

Handicap of the patient with vestibular disease can be measured by means of scales and questionnaires. The utility of a questionnaire developed and validated in Spanish language is commented (CEMPV). The CEMPV consists of 46 questions distributed in three scales (emotional, functional and organic) whose obtained scores are related to diverse degrees of handicap (global, emotional, functional and organic). The CEMPV is self-employed and evaluates the evolution of the patient and allows to accredit the results obtained between different investigators.

Dizziness↗
PubMed1998

Vestibular disease unmasked by hyperventilation.

Hyperventilation-induced dizziness is often thought to be psychogenic, but its effects in the presence of known vestibular disease have not been adequately examined. In this study hyperventilation was tested in two models of vestibular disease. These were, first, patients with profound unilateral vestibular deficit (prior translabyrinthine acoustic neuroma resection [postsurgery group]) and, second, patients with variable unilateral vestibular deficit (unoperated unilateral acoustic neuroma [presurgery group]). Patients were hyperventilated for 90 seconds. Using infrared videonystagmography, 100% of the 32 postsurgery patients and 82% of the 28 presurgery patients developed nystagmus with hyperventilation. Hyperventilation was more sensitive than head shake for eliciting nystagmus in these models. The false-positive rate for nystagmus in 29 normal volunteers was 3.5% for hyperventilation and 10% for head shake. Our results show that hyperventilation can unmask underlying vestibular disease.

Dizziness↗
PubMed2005

Signs of neurologic dysfunction in dogs with central versus peripheral vestibular disease.

OBJECTIVE: To determine the frequency of specific signs of neurologic dysfunction in dogs with central vestibular disease (CVD) or peripheral vestibular disease (PVD) and whether the degree of head tilt, rate of nystagmus, and number of beats of postrotatory nystagmus can be used to help distinguish CVD from PVD. DESIGN: Prospective clinical study. ANIMALS: 40 client-owned dogs with vestibular system dysfunction. PROCEDURE: A standard neurologic examination was performed, along with an expanded vestibular system examination that assessed the degree of head tilt, rate of nystagmus, and number of beats of postrotatory nystagmus. RESULTS: Dogs with CVD were significantly more likely to be nonambulatory than were dogs with PVD. Dogs with PVD were significantly more likely to veer or lean in 1 direction and to have resting nystagmus than were dogs with CVD. Median rate of resting nystagmus was significantly higher for dogs with PVD, but no significant differences between groups were detected in regard to presence or degree of head tilt, presence of positional ventral strabismus, and number of beats of postrotatory nystagmus. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that nonambulatory tetraparesis is significantly more common in dogs with CVD and veering and leaning are significantly more common in dogs with PVD. Although neither the degree of head tilt nor the number of beats of postrotatory nystagmus could be used to distinguish CVD from PVD, rate of resting nystagmus may be useful in distinguishing the 2 conditions.

Animals↗
PubMed1991

New posture equilibrometer for the diagnosis of vestibular disease.

The vestibulospinal level of vestibular function is commonly neglected in the evaluation of vertiginous patients. We have now developed a new posture equilibrometer. A transducer is placed on the head of the subject being tested. With this meter we can record body swaying, X (left-right) and Y (fore-aft) components of angular displacement, angular velocity, and angular acceleration. A detailed analysis of the data can be made by having patients keep their eyes either open or closed during the Romberg test. The head is turned left or right in this test, while the eyes are opened and closed in the Mann test. The posture equilibrometer has enabled us to evaluate more precisely vestibulospinal function and sensory interactions.

Adolescent↗
PubMedDate not supplied

[Trial of amitriptyline versus flunarizine as treatment of vestibular diseases. A preliminary study].

109 patients with vestibular disease were included in two different treatments with amitriptyline (Group A:53 patients with depressive symptoms), or flunarizine (Group B: 56 patients). Vertiginous symptoms, basic vestibular exploration, depressive disorder, cochlear symptoms, vegetative disorders and headache were evaluated. Among the patients treated with amitriptyline a significant decrease in the vertiginous symptoms were observed. The possible mechanism of action were analyzed too.

Amitriptyline↗
PubMed2000

Peripheral vestibular disease associated with cryptococcosis in three cats.

Peripheral vestibular disease referable to otitis media/interna was the main reason for presentation in three cats with cryptococcosis. In two cats, Cryptococcus neoformans var neoformans was isolated from the tympanic bulla. In the remaining cat, otitis media/interna was considered to be secondary to occlusion of the auditory tube by a nasopharyngeal granuloma associated with a C neoformans var gattii infection. This report emphasises the importance of maintaining an index of suspicion for a fungal aetiology in cats with signs of otitis media/interna, particularly in countries with a high prevalence of cryptococcosis. The presence of C neoformans may be overlooked with potentially fatal consequences where only standard methods for bacterial isolation are used to examine samples obtained from the middle ear.

Animals↗
PubMed2006

Depersonalisation/derealisation symptoms in vestibular disease.

BACKGROUND: Depersonalisation is a subjective experience of unreality and detachment from the self often accompanied by derealisation; the experience of the external world appearing to be strange or unreal. Feelings of unreality can be evoked by disorienting vestibular stimulation. OBJECTIVE: To identify the prevalence of depersonalisation/derealisation symptoms in patients with peripheral vestibular disease and experimentally to induce these symptoms by vestibular stimulation. METHODS: 121 healthy subjects and 50 patients with peripheral vestibular disease participated in the study. For comparison with the patients a subgroup of 50 age matched healthy subjects was delineated. All completed (1) an in-house health screening questionnaire; (2) the General Health Questionnaire (GHQ-12); (3) the 28-item depersonalisation/derealisation inventory of Cox and Swinson (2002). Experimental verification of "vestibular induced" depersonalisation/derealisation was assessed in 20 patients and 20 controls during caloric irrigation of the labyrinths. RESULTS: The frequency and severity of symptoms in vestibular patients was significantly higher than in controls. In controls the most common experiences were of "déjà vu" and "difficulty in concentrating/attending". In contrast, apart from dizziness, patients most frequently reported derealisation symptoms of "feel as if walking on shifting ground", "body feels strange/not being in control of self", and "feel 'spacey' or 'spaced out'". Items permitted discrimination between healthy subjects and vestibular patients in 92% of the cases. Apart from dizziness, caloric stimulation induced depersonalisation/derealisation symptoms which healthy subjects denied ever experiencing before, while patients reported that the symptoms were similar to those encountered during their disease. CONCLUSIONS: Depersonalisation/derealisation symptoms are both different in quality and more frequent under conditions of non-physiological vestibular stimulation. In vestibular disease, frequent experiences of derealisation may occur because distorted vestibular signals mismatch with the other sensory input to create an incoherent frame of spatial reference which makes the patient feel he or she is detached or separated from the world.

Adult↗
PubMedDate not supplied

Vestibular disease and cognitive dysfunction: no evidence for a causal connection.

OBJECTIVE: To evaluate the contribution of vestibular pathology to cognitive and affective complaints of patients with and without brain trauma. SETTING: An outpatient balance disorders clinic within a tertiary care neuroscience institute. PARTICIPANTS: 200 patients with dizziness--half with a recent history of brain trauma and half without. MAIN OUTCOME MEASURES: The Dizziness Handicap Inventory, the Beck Depression Inventory, and the Neurobehavioral Symptom Inventory were prospectively administered. Neurological examination and vestibular testing were performed to arrive at a diagnosis for the dizziness. Multiple regression analyses were carried out using vestibular diagnosis, psychiatric diagnosis, and trauma history as predictors of the inventory scores. RESULTS: Perceived disability was higher in dizzy patients with a history of brain trauma compared with dizzy patients without a history of trauma. A diagnosis of vestibular disease had no influence on perceived disability. Similarly, cognitive complaints were more common in dizzy patients with a history of brain trauma compared to dizzy patients without a history of trauma, but a diagnosis of vestibular disease had no influence on the frequency of cognitive complaints. CONCLUSIONS: In patients with postconcussive dizziness, cognitive complaints are likely due to neurologic injury or affective disturbance. In dizzy patients without brain trauma, cognitive complaints are likely due to concurrent affective disturbance.

Adult↗
PubMed1989

A posture equilibrometer for the diagnosis of vestibular disease.

Since the vestibulospinal level of vestibular function is frequently neglected in the evaluation of vertiginous patients, we developed a new posture equilibrometer for recording body swaying X (left-right) and Y (fore-aft) components of angular displacement, velocity, and acceleration with its transducer on the head of the subject. The data from patients undergoing Romberg test with eyes open and closed, Romberg test with head turned left and right and Mann test were analysed. We conclude that the equilibrometry allows one to evaluate precisely the vestibulospinal function and the sensory interaction.

Adolescent↗
PubMedDate not supplied

Frequency analysis of body sway in the upright posture. Statistical study in cases of peripheral vestibular disease.

The frequency component of shift in the centre of gravity while standing upright was investigated in 14 normal subjects and 30 patients with peripheral vestibular disease. Relative changes in the square root value of the power in each small frequency band of 0.1 and 0.2 Hz in frequencies of less than 2 Hz were evaluated statistically for four groups, viz. a group of normal subjects, and patients with Ménière's disease, benign paroxysmal positional vertigo, and vestibular neuritis. The influence of visual control in each group and the difference between each pathological group and the normal subjects were examined statistically. The combination of a minor change in each small frequency band is considered to be utilizable to establish a differential diagnosis for the three groups of peripheral vestibular disease and versus the normal group.

Adult↗